Trimodal prehabilitation for hematopoietic stem cell transplantation: A best evidence summary

To systematically evaluate and synthesize the best practice evidence of trimodal prehabilitation comprising exercise, nutritional optimization, and psychological support in patients undergoing hematopoietic stem cell transplantation, so as to enhance patients' physiological reserve and stress resistance, and provide a scientific basis and practical reference for formulating individualized prehabilitation programs in clinical practice.

A comprehensive computerized literature search was conducted across multiple databases and evidence sources, including UpToDate, BMJ Best Practice, Guidelines International Network, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, National Guideline Clearinghouse, Registered Nurses Association of Ontario, Joanna Briggs Institute, World Health Organization, Cochrane Library, Web of Science, PubMed, CINAHL, China National Knowledge Infrastructure, Wanfang Data, and SinoMed. The search timeframe encompassed literature from September 2015 to September 2025.

A total of 11 publications were included, comprising 1 clinical guideline, 2 expert consensus documents, 1 evidence summary, 3 systematic reviews, and 4 randomized controlled trials. The evidence was synthesized across five domains: multidisciplinary team building, exercise prescription, nutritional optimization, psychological support, and precautionary considerations, resulting in the formulation of 34 distinct evidentiary statements.

This study synthesizes the best available evidence on trimodal prehabilitation for patients undergoing hematopoietic stem cell transplantation, providing an evidence-based foundation for standardizing pre-transplant rehabilitation management. It is recommended that healthcare professionals, when implementing these recommendations, comprehensively consider the specific clinical context to selectively apply the most appropriate evidence, with the aim of improving patient transplant outcomes.

This study was registered at the Fudan University Center for Evidence-Based Nursing (Registration No. ES20259181).